SSRI
Name 3 SSRI’s that have been FDA approved for the treatment of OCD:
fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa)
Name 3 out of 4 SNRIs approved for use in the US:
venlafaxine (Effexor and effexor XR), desvenlafaxine succinate (DVS; Pristiq), duloxetine (Cymbalta), and levomilnacipran (Fetzima).
Atypical antipsychotics mode of action is blockade of what receptors:
D2 Dopamine receptors
Which TCA has the most antihistaminergic activity?
Doxepin (sinequan, quitaxon)
True or false:
Divalproex has additional indications for prophylaxis of migraines.
true
Which SSRI has the most significant drug-drug interactions:
Fluvoxamine
What distinguishes the SNRIs from TCAs is their relative lack of affinity for other receptors. What receptors are these?
muscarinic, histaminergic, and the families of α- and β-adrenergic receptors. This distinction is an important one because the SNRIs have a more favorable tolerability profile than the older dual reuptake inhibitors.
Other than clozapine, which atypical antipsychotic causes a greater amount and more frequent weight gain than others atypicals
Olanzapine
Which TCA is the only TCA FDA approved for treatment of OCD?
Clomipramine
Antimanic response is generally associated with what valproic acid range (ug/ml)?
range of 50 to 150 μg/mL.
Which SSRI in combination with a behavioral program, has been shown to be only modestly beneficial for weight loss.
Fluoxetine
Venlafaxine is approved for treatment of four disorders. What are they?
major depressive disorder, generalized anxiety disorder, social anxiety disorder, and panic disorder.
All atypical antipsychotics are FDA approved for treatment of acute mania, except for:
clozapine
Although TCAs are more likely to cause constipation, sedation, dry mouth, or lightheadedness than the SSRIs, the TCAs are less prone to cause the following side effects that SSRIs typically cause:
sexual dysfunction, significant long-term weight gain, and sleep disturbances.
Thus TCAs represent a reasonable alternative for persons who cannot tolerate the adverse effects of the SSRIs.
Why is Depakote called valproic acid?
It is called valproic acid because it is rapidly converted to the acid form in the stomach.
What percentage of persons taking SSRIs note trouble sleeping, excessive somnolence, or overwhelming fatigue
25%
What side effect is the most frequently reported treatment-emergent adverse effect associated with venlafaxine and DVS therapy.
Nausea
Other than Clozapine, which atypical antipsychotic is least likely to cause EPS regardless of dose?
Quetiapine (Seroquel)
Which TCA is often used to treat Childhood enuresis?
Imipramine (Tofranil).
How is Valproate primarily metabolized?
hepatic glucuronidation and mitochondrial β oxidation.
True or False: Escitalopram is more likely to interfere with sleep than its isomer, citalopram.
true
In clinical trials lasting 6 months, what dosage range was effective in treating insomnia, poor concentration, restlessness, irritability, and excessive muscle tension related to generalized anxiety disorder.
dosages of 75 to 225 mg a day
What dose range can Quetiapine be used to treat insomnia?
25 to 300 mg at night
Although introduced as antidepressants, the therapeutic indications for TCAs have grown to include the following disorders/syndromes:
panic disorder, GAD, PTSD, OCD, and pain syndromes
what percentage of people with acute mania respond to valproate?
2/3 (67%)